SuppLementary Materials
Appendix A:Characteristics of Included Primary Studies (n=207)
Studiesare divided into health domains, and then sorted by major topic area, then first author.
Physical Health
Author (Year) / Objectives / Pub Lng / Countries(Income Class) / Study Type / Study Focus[i] / Health Domains
Comorbidities (e.g., non-HIV related cancers, cardiovascular, endocrine/metabolic, kidney, lung, musculoskeletal, neurological conditions)
Bini et al. (2006)13 / To determine the utility of screening flexible sigmoidoscopy in patients with HIV. / English / United States (High) / Quantitative (Cross-Sectional) / HIV-50+ / Cancer (colorectal cancer)Bini et al. (2009)12 / To evaluate the prevalence of colorectal neoplasms in HIV-infected individuals aged 50 years and older. / English / United States (High) / Quantitative (Case Control) / HIV-50+ / Cancer (colorectal cancer neoplasms )
Crum et al. (2004)29 / To evaluate the incidence of prostate carcinoma in the cohort of HIV+ men aged ≥35 and to investigate the usefulness of prostate carcinoma screening in this population. / English / United States (High) / Quantitative (Prospective Cohort) / Age / Cancer (prostate cancer)
Goedert et al. (2006)59 / To investigate whether the risk of breast, ovary, or uterine corpus cancers differ for women with AIDS; whether breast cancer risk differs with increasing severity or duration of immune deficiency, or with increasing availability and efficacy of anti-HIV therapies; also whether menopause or selected risk factors modify or explain any associations. / English / United States (High) / Quantitative (Prospective Cohort) / Age / Cancer (breast cancer, ovarian cancer, uterine cancer)
Hsiao et al. (2009)83 / To review the relationship between HIV infection and prostate cancer in a contemporary series of prostate biopsy patients. / English / United States (High) / Quantitative (Retrospective Cohort) / Age
HIV+/HIV- / Cancer (prostate cancer)
Lanoy et al. (2010)100 / To investigate immunosuppression as a risk factor for the development of skin cancers among elderly adults in the United States. / English / United States (High) / Quantitative (Case Control) / HIV+/HIV- / Cancer (melanoma, appendageal carcinoma)
HIV/AIDS related symptoms (Kaposi sarcoma)
Magalhaes et al. (2007)108 / To determine the prevalence of selected clinical and hematologic comorbidities that may affect the deliveryof or health care to older patients with HIV. / English / United States (High) / Quantitative (Retrospective Cohort) / HIV-50+ / Cancer
Cardiovascular (hypertension, heart disease, stroke)
Endocrine - Metabolic (diabetes)
Hematologic (anemia)
Kidney (kidney disease)
Pulmonary (pulmonary disease)
Musculoskeletal (orthopedic disease)
Neurological (neurological disorders)
Opportunistic infections (tuberculosis,hepatitis C(HCV))
Önen (2010a)127 / To evaluate comorbidities, cardiovascular risk, cognitive function and anthropomorphic and laboratory parameters among HIV-infected persons aged 50 years and over and compare them to data from matched individuals in the National Health and Nutrition Examination Survey (NHANES) database. / English / United States (High) / Quantitative (Cross-Sectional) / HIV+/HIV- / Cancer (non-AIDS-defining malignancies)
Cardiovascular (hypertension, hypertriglyceridemia, cardiovascular risk, coronary heart disease)
Endocrine-Metabolic (diabetes mellitus)
Musculoskeletal (low bone mineral density)
HIV/AIDS related symptoms (lipodystrophy)
Opportunistic infections (chronic viral hepatitis)
Vianna et al. (2006)190 / To determine the rate of, and factors associated with, elevated prostate-specific antigen (PSA) levels in older men with or at risk of HIV infection. / English / United States (High) / Quantitative (Cross-Sectional) / Age
HIV+/HIV- / Cancer (elevated prostate-specific antigen)
Wasserberg et al. (2007)192 / To investigate the incidence, presentation, and outcome of colorectal cancer (CRC) in HIV patients. / English / United States (High) / Quantitative (Case Control) / Age / Cancer (colorectal cancer)
Baekken et al. (2008)5 / To assess the prevalence of hypertension in an HIV-infected population and to identify possible predictors. / English / Norway (High) / Quantitative (Cross-Sectional) / Age / Cardiovascular (hypertension)
Carr et al. (2008)24 / To study asymptomatic ischaemic heart disease (IHD) in HIV-infected patients. / English / 318 sites in 33 countries / Quantitative (Prospective Cohort) / Age / Cardiovascular (asymptomatic ischaemic heart disease (IHD))
Foley et al.(2010)54 / To examine the interactive effects of cerebrovascular risks, advancing age, and HIV infection on neurocognition, and explored whether pharmacological treatment of cerebrovascular risk factors attenuated neurocognitive dysfunction. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Cardiovascular (Cerebrovascular risk)
Goulet et al. (2007)65 / To compare comorbidity among veterans with and without HIV infection. / English / United States (High) / Quantitative (Prospective Cohort) / Age
HIV+/HIV- / Cardiovascular (Vascular disease)
Kidney (Renal disease)
Pulmonary(Pulmonary disease)
McMurtray et al. (2007)112 / To determine the relationship between age and occurrence of cerebral manifestations of small-vessel ischemic vascular disease in human immunodeficiency virus (HIV)-seropositive individuals. / English / United States (High) / Quantitative (Prospective Cohort) / Age / Cardiovascular (Ischemic vascular disease)
Neurological (cerebral manifestations of small-vessel ischemic vascular disease)
Orlando et al. (2006)130 / To evaluate immunovirological outcomes and the incidence rate of adverse metabolic events or new comorbidities in the first year of antiretroviral treatment in an HIV-infected cohort of patients aged 50 years or older. / English / Italy (High) / Quantitative (Retrospective Cohort) / Age / Cardiovascular (Cardiovascular disorders)
Endo-metabolic (Endocrine-metabolic disorders)
Neurological (neuralgic disorders)
Oursler et al. (2011)131 / To investigate the relationship of self-reported physical function with prevalent age-associated conditions defined by ICD-9 codes at the baseline visit for HIV-infected and uninfected patients enrolled in the Veterans Aging Cohort Study-8 Site (VACS-8). / English / United States (High) / Quantitative (Cross-Sectional) / Age
HIV+/HIV- / Cardiovascular (cardiovascular disease)
Pulmonary(chronic obstructive lung disease)
Physical well-being (physical functioning, obesity)
Vance (2011)188 / To examine patterns of comorbidities, and immunological and clinical characteristics across each decade of life using a sample of adult patients seen at an HIV clinic. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Cardiovascular (coronary artery disease, hypertension)
Endocrine-Metabolic (hypercholesterolemia, diabetes)
Kidney (kidney disease)
HIV-markers (HIV viral load, CD41 T lymphocyte)
Adeyemi et al. (2008)1 / 1) To determine the prevalence and predictors of metabolic syndrome among a cohort of older (defined as older than 50 years), HIV-infected patients, most of whom are ethnic minorities and; 2) To calculate the 10-year Framingham cardiac risk (FCR) score in this cohort and identify any association between metabolic syndrome and elevated 10-year FCR scores in this cohort. / English / United States (High) / Quantitative (Cross-Sectional) / HIV-50+ / Endocrine/Metabolic (metabolic syndrome)
Butt (2009)21 / To determine the association of HIV infection itself with diabetes mellitus, and studied the factors that predicted diabetes mellitus in HIV infected and uninfected groups. / English / United States (High) / Quantitative (Prospective Cohort) / Age
HIV+/HIV- / Endocrine/metabolic (diabetes)
Howard et al. (2007)82 / To determine the associations of Hepatitis C virus (HCV) infection with insulin resistance and abnormal glucose tolerance in a cohort of older adults with or at risk for HIV infection. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Endocrine-Metabolic (insulin resistance)
Opportunistic infections (hepatitis (HCV))
Silverberg et al.(2009)166 / To compare the prevalence of gastrointestinal, metabolic, general malaise, neurologic, or other self-reported symptoms by age and race/ethnicity in HIV+ men and women. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Endocrine-Metabolic (metabolic symptoms)
Gastrointestinal (gastrointestinal symptoms)
Neurological (neurologic symptoms)
Physical well-being (general malaise)
Sternfeld et al. (2009)172 / To determine whether Methionine breath test as a marker for hepatic mitochondrial function in HIV-infected patients. / English / Germany (High) / Quantitative (Cross-Sectional) / Age / Endocrine-Metabolic (hepatic mitochondrial function)
Valcour et al. (2005)184 / To examine the relationship between HIV-associated dementia (HAD) and diabetes among patients with HIV-1 infection. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Endocrine-Metabolic (diabetes)
Wiener et al. (2008)196 / To evaluate the prevalence of and factors associated with abnormal thyroid function in older men with or at risk for HIV infection. / English / United States (High) / Quantitative (Cross-Sectional) / HIV+/HIV- / Endocrine-Metabolic (Endocrine/metabolic: thyroid function)
Worm et al. (2009)202 / To investigate the impact of diabetes mellitus (DM) and preexisting coronary heart disease (CHD) on the development of a new CHD episode among HIV-infected individuals. / English / Australasia, Europe; and North America / Quantitative (Prospective Cohort) / Age / Endocrine-Metabolic (Diabetes)
Cardiovascular (Coronary heart disease)
Siegel et al. (2010)163 / To examine the emotional impact of diarrhea among HIV late middle-age and older adults (i.e., age 50 years and older). / English / United States (High) / Qualitative / HIV-50+ / Gastrointestinal (diarrhea)
Campbell et al. (2009)23 / To investigate the prevalence and aetiology of chronic kidney disease (CKD) and trends in estimated glomerular filtration rate (eGFR) in HIV-infected patients. / English / United Kingdom (High) / Quantitative (Prospective Cohort) / Age / Kidney (chronic kidney disease,glomerular filtration rate)
Crane et al. (2007)28 / To examine the effect of antiretroviral agents and clinical factors on the development of tenofovir-associated kidney dysfunction. / English / United States (High) / Quantitative (Retrospective Cohort) / Age / Kidney (kidney dysfunction)
Wyatt et al. (2007)205 / To understand chronic kidney disease in HIV infection. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Kidney (kidney disease)
Benito et al. (2001)10 / To study the incidence, etiology, and outcome of pulmonary infiltrates (PIs) in HIV-infected patients and to evaluate the yield of diagnostic procedures. / English / Spain (High) / Quantitative (Prospective Cohort) / Age / Lung(Pulmonary infiltrates)
Mortality/survival
Jones et al. (2008)88 / To compare the prevalence of decreased bone mineralization and associated risk factors in a cohort of older men and post-menopausal women to an HIV uninfected control population. / English / United States (High) / Quantitative (Cross-Sectional) / HIV+/HIV- / Musculoskeletal (Bone mineral density (BMD)
Sharma et al. (2010)153 / To investigate rates and predictors of change in bone minerak density (BMD) in a cohort of aging men with or at risk for HIV infection. / English / United States (High) / Quantitative (Prospective Cohort) / HIV+/HIV- / Musculoskeletal (osteoprosis, osteopenia)
Evans et al. (2011)52 / To estimate neuropathic sign/symptom rates with initiation of combination antiretroviral therapy (cART) in HIV-infected ART-naive patients, and to investigate risk factors for: peripheral neuropathy and symptomatic peripheral neuropathy (SPN), recovery from peripheral neuropathy/SPN after neurotoxic ART(nART) discontinuation, and the absence of peripheral neuropathy/SPN while on nART. / English / United States (High) / Quantitative (Prospective Cohort) / Age / Neurological (peripheral neuropathy)
Justice et al. (2008)89 / To estimate the background rate of intracranial hemorrhage (ICH) and compared it with rates reported among persons who had been exposed to tipranavir. / English / United States (High) / Quantitative (Case Control) / Age
HIV+/HIV- / Neurological (intracranial hemorrhage)
McMurtray et al. (2008)113 / To determine the relationship between white matter hyperintensities (WMHs) and cortical volumes in HIV-seropositive individuals. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Neurological (Cortical atrophy)
Watters et al. (2004)194 / To determine if aging changes the frequency, severity, or manifestations of symptomatic distal sensory polyneuropathy (SxDSPN) in patients with HIV-1. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Neurological (Symptomatic distal sensory polyneuropathy)
Keller et al. (1999)92 / To characterize person 50 years and over with HIV/AIDS and to evaluate trends in the length of survival. / English / United States (High) / Quantitative (Retrospective Cohort) / HIV-50+ / Other comorbidities(not specified)
Mortality/survival
Opportunistic infections
Lyons et al. (2010)107 / To explore the health and psychosocial well-being of older Australian HIV-postive gay men compared with middle-aged and young HIV-positive gay men. / English / Australia (High) / Quantitative (Cross-Sectional) / Age / Other comorbidities(not specified)
Mothe et al. (2009)117 / To describe a cohort of HIV-1-infected patients aged 70 years or more, in order to identify specific clinical characteristics of this growing population. / English / Spain (High) / Quantitative (Cross-Sectional) / HIV-50+ / Other comorbidities(not specified)
HIV/AIDS-related symptoms (lipodystrophy)
Nokes et al. (2000)124 / To identify if there were differences in variables predicting health-related quality of life as conceptualized by Wilson and Cleary (1995) for people with HIV disease who were either age 50 or older or younger than age 50. / English / United States (High) / Quantitative (Cross-Sectional) / Age / Other comorbidities(not specified)
Physical well-being (physical functioning, HR-QOL)
Nokes et al. (2011)123 / To explore whether the chronological age of persons with HIV/AIDS impacts two domains of the model: symptom status and health-related quality of life. / English / Taiwan(Upper-Mid)
Norway (High)
Puerto Rico (High)
United States (High) / Quantitative (Cross-Sectional) / Age / Other comorbidities(not specified)
HIV/AIDS-related symptoms
Physical well-being (HR-QOL)
Oursler et al. (2006)132 / To investigate the relationship of comorbidity and age with physical functioning in HIV-infected and HIV-negative patients. / English / United States (High) / Quantitative (Prospective Cohort) / Age
HIV+/HIV- / Other comorbidities(not specified)
Physical well-being (physical functioning)
Pitts et al. (2005)136 / To describe social and economic circumstances of older HIV-positive Australians. / English / Australia (High) / Quantitative (Cross-Sectional) / Age / Other comorbidities(not specified)
Physical well-being
Power et al. (2010)140 / To describe the needs, concerns and characteristics of people aged 50 and over who are living with HIV in the UK. / English / United Kingdom (High) / Mixed methods (Cross-Sectional) / HIV-50+ / Other comorbidities(not specified)
Physical well-being (mobility)
Shah (2002)152 / To examine comorbid conditions and health maintenance in 198 patients aged +55 years who attended 3 New York City human immunodeficiency virus (HIV) clinics between 1 January 1990 and 30 June 1998. / English / United States (High) / Quantitative (Retrospective Cohort) / HIV-50+ / Other comorbidities(not specified)
Medications (concurrent medications, polydrug use)
Siegel et al. (1999a)157 / To elucidate some of the difficulties that late-middle-aged and older HIV-infected individuals reported in interpreting and appraising their own symptoms. / English / United States (High) / Qualitative / HIV-50+ / Other comorbidities (symptom ambiguity)
Siegel et al. (2004a)156 / To better understand the symptom appraisal process amongHIV+ adultsand their experience with fatigue. / English / United States (High) / Qualitative / HIV-50+ / Other comorbidities (symptom ambiguity)
Physical well-being (fatigue)
Tyler (2006)178 / To understand the intersection of HIV/AIDS and aging as processes affecting the lives of older adults living with HIV/AIDS and the meaning of their experiences with the disease in the context of their individual life course. / English / United States (High) / Qualitative / HIV-50+ / Other comorbidities (symptom ambiguity)
HIV markers *e.g., CD 4 counts, HIV viral load)
Emlet & Farkas (2001)49 / To describe characteristics of older HIV population. / English / United States (High) / Quantitative (Cross-Sectional) / Age / HIV markers (CD4 counts)Goetz (2001)60 / To investigate the number of CD4 lymphocytes in older HIV-infected patients. / English / United States (High) / Quantitative (Retrospective Cohort) / Age / HIV markers (CD4 counts)
Goodkin et al. (2004)62 / To examine the relationship between age and plasma viral load in HIV-1-infected individuals. / English / United States (High) / Quantitative / Age / HIV markers (plasma viral load)
Valcour et al. (2006)186 / To determine the reliability of self-reported CD4 nadir and its predictive value for neurological status. / English / United States (High) / Quantitative (Cross-Sectional) / Age / HIV markers (CD4 lymphocyte count)
Yung & Mo (2003)206 / To examine the effects of aging on CCR gene expression in human peripheral blood mononuclear cells (PBMCs), CD4+ T cells, and naive/memory T cells. / English / United States (High) / Quantitative (Cross-Sectional) / Age / HIV markers (CCR gene expression, CD4+ T cells, and naive/memory T cells)
HIV/AIDS-related symptoms (e.g., HIV-presenting symptoms, AIDS-defining illnesses, HIV-related cancers, disease progression)
Anton et al. (2005)4 / To study clinical and epidemiological study of a series of HIV-infected patients over 50 years old. / Spanish / Spain (High) / Quantitative (Cross-Sectional) / HIV-50+ / HIV/AIDS related symptoms (HIV-presenting symptoms)Baratin et al.(2004)7 / To describe the characteristics of individuals with AIDS occurring shortly after their initial diagnosis of HIV seropositivity, since the beginning of the AIDS epidemic in 1985. / English / France (High) / Quantitative (Prospective Cohort) / Age / HIV/AIDS related symptoms (Disease progression - AIDS diagnosis)
Dorrucci et al. (2003)36 / To investigate the relationship among HIV-induced immunosupression, aging and Kaposis Sarcoma, taking in to account the duration of HIV infection, the level of immunosupression, and the prevalence of Human Herpes Virus Type 8 (HHV-8) infection. / English / Italy (High) / Quantitative (Prospective Cohort) / Age / HIV-AIDS related symptoms (Kaposi Sarcoma)
Grimes et al. (2002)69 / To investigate whether the progression of HIV disease in older persons has been altered since the advent of effective treatment. / English / United States (High) / Quantitative (Retrospective Cohort) / Age / HIV/AIDS related symptoms (disease progression)
Opportunistic infections (candidiasis)
Hall et al. (2006)72 / To determine factors associated with disease progression after human immunodeficiency virus (HIV) infection diagnosis. / English / United States (High) / Quantitative (Time Series Analysis) / Age / HIV/AIDS related symptoms (Disease progression)
Mortality/Survival
Ibara et al. (2002)84 / To estimate the frequency of AIDS occurring in older age groups on the basis of hospital statistics and note the prognostic particularities in these groups. / French / Congo, Democratic Republic(Low-Mid) / Quantitative (Cross-Sectional) / HIV-50+ / HIV/AIDS-related symptoms (disease progression)
Inungu et al. (2001)85 / To examine HIV risk factors among patients ages 50 years or older at HIV diagnosis and assessed differences in the prevalence of AIDS-defining conditions and in the progression of HIV infection to death among persons ages 50 years or younger compared with those ages 13 to 49 years. / English / United States (High) / Quantitative (Cross-Sectional) / Age / HIV/AIDS-related symptoms (disease progression, AIDS-defining conditions)
Mortality/Survival
Lacerda & Kitner (2008)99 / To compare the outcome of an elderly group of AIDS patients with that of a younger group and their features at the time of the diagnosis of AIDS. / English / Brazil (Upper-Mid) / Quantitative (Case Control) / Age / HIV/AIDS related symptoms (AIDS defining diseases)